By Kiera Nagle, MA, LMT
Are you a parent or considering parenthood? As we grow through our 20s, 30s, and 40s, the question of parenthood often crosses our minds and becomes part of our conversations, whether we are partnered or not. While there are undoubtedly innumerable joys that come from parenting, one of the major concerns that many folks will have is how or whether the process of conception, the impact of pregnancy, the recovery of postpartum, and the inevitable stresses of parenting may impact their health and well-being. These are important aspects of this major life shift to explore and consider. Some couples may find that even if they are psychologically ready, they may struggle with fertility, while others may think they will have adequate time to transition, only to find that they are suddenly pregnant and faced with a myriad of changes and choices. Some folks may breeze through a pleasant pregnancy, only to face difficulty with labor or in the postpartum period. Many non-pregnant partners may deal with their own stressors as they figure out what role they will play in all aspects of these life shifts. Some individuals may find themselves personally ready for the experience of parenthood, but unpartnered, and in a position to pursue options to make the journey alone. One wellness approach that can help support all facets of these experiences and the way they impact human beings physiologically and psychologically is massage therapy. Let’s explore each phase of the childbearing years and how massage may be of support.
Conception and Fertility
It is commonly known that age has a significant impact on fertility. If you are under 30, you have a less than 10% chance of miscarriage, however, by the age of 35, that increases to 15%, and by 40 it doubles to over 30%. Some folks assume that after years of preventing pregnancy through various means (birth control and other contraceptives) as soon as they are ready to get pregnant, they will have no issue. But unfortunately, some studies have shown that after ceasing BC, there may be at least a few months’ delay before conception is possible. In addition, the body may need some time to adjust after going off birth control, and this process might include some uncomfortable symptoms, such as irregularity of the menstrual cycle, amenorrhea (missing periods), dysmenorrhea (painful periods), PMS, mood fluctuations, weight gain and changes in libido.
How can massage help? There really isn’t any good evidence specifically defining how massage can impact fertility. However, there is very good evidence for massage impacting some of the symptoms outlined above. For example, in a 2015 study of 102 patients experiencing dysmenorrhea, pain intensity was significantly reduced in the group that received aromatherapy massage with lavender oil, even more so than in the group who exercised. In another study from the same year, even self-massage was found to be effective for reducing the pain of dysmenorrhea, especially if aromatherapy (in this case, rose oil) was included. Acupressure massage was also found to be a helpful intervention for reducing “menstrual distress” and low back pain associated with menstruation in this 2014 study. Partner-administered reflexology was also found to be effective for reducing pain and anxiety for clients with complicated illness in this earlier study from 2007. So, while it would be unethical to say that massage can help support fertility, the impact massage can have on the pain, discomfort, and anxiety that may accompany the period of transitioning off birth control or going through assisted reproductive technology processes (which may result in similar symptoms and stresses) can be self-supportive and provide positive connections with our bodies and our partners.
Pregnancy and Labor
During pregnancy, the human body proceeds rapidly through profound changes in a relatively short period of time. Each trimester is marked with physical symptoms and emotional impacts, which may be an adjustment for the pregnant person, even if they are not experienced as particularly uncomfortable (though for some, they may be.) In the first trimester, fatigue, bloating, and nausea are common. In the second trimester, we begin to see the postural impacts with frontal weight gain and the shifting of skeletal structure. Shortness of breath, abdominal pressure, and low back pain may begin in the second trimester and become more exacerbated in the third. In this final trimester, as the pressure on the pelvis increases, and there is more restriction to the major blood vessels of the lower body, pregnant people may experience swelling in the limbs. With the presence of the hormone relaxin softening the tissues throughout the body, some may experience joint instability, especially if they were already prone to hypermobility. Throughout the experience of pregnancy, people may be defining their new identities as parents through a psychological process called “cognitive restructuring” or they may experience symptoms of anxiety and depression for various reasons.
There is significant evidence to show the benefits of massage therapy for pregnancy, and incredibly, these can also impact the baby by supporting a healthy in-utero environment. In one study published in 2012, 84 patients diagnosed with prenatal depression received twice-weekly massage and yoga sessions for 12 weeks. Compared to the control group (who received no intervention), the recipients of massage and yoga had decreased symptoms of depression and anxiety, decreased pain scales, and gave birth to babies of greater gestational age and higher birth weights. Babies who are not born pre-term, and are born with higher birth weights, are less likely to need medical intervention.
What are some other benefits of massage for the pregnant person themselves? Self- administered acupressure on the pericardium 6 acupoint has been shown in several studies to significantly reduce nausea in the first trimester. Reflexology and hydrotherapy have positive impacts on reducing edema (swelling) in pregnancy as does manual lymph drainage. Aromatherapy massage was shown to have a significantly positive impact on stress and immune function during pregnancy. This amazing study from 2008 showed that partner-administered prenatal massage reduced pain in the pregnant recipient, and improved the mood of both the pregnant recipient and the partner/caregiver and their relationship with each other. This was reinforced with a more recent study in 2021.
Some studies have shown the effectiveness of acupressure and sacral massage on relieving labor pain and reducing labor time. There have also been positive outcomes for perineal self-massage prior to labor reducing and preventing perineal trauma during birth. The plethora of positive impacts massage therapy can have for the pregnant person, their partner, and the baby seems infinite. Touch is associated with the release of the hormone oxytocin. The chemical impact of oxytocin in labor is to promote the normal physiological process of labor, reducing the need for medical intervention, induction, and/or augmentation, which increase the possibility of trauma for the pregnant couple and their baby.
Postpartum Recovery and Lactation
The postpartum period is an often overlooked and under-supported phase for many parents. There is often much focus in treatment during pregnancy and preparation for labor, but a lack of acknowledgement of the needs of postpartum recovery. Once again, there is a significant physical and psychological adjustment that is occurring, and for first time parents, the additional aspect of adjusting to newborn infant care.
While recovery from a birth that did not require as much medical intervention is not minimal, there are also the potential complications that recovering from c-section surgery will involve. Several studies looked at how massage can help reduce pain after c-section. Hand and foot massage administered within 1-2 days after delivery can reduce pain intensity for clients with this more complex version of postpartum recovery.
The hormonal shifts that occur in this period can also increase the possibility of postpartum depression. Another study from 2015 explored how reflexology, given once a day for 3 days consecutively in the early postpartum period, can help to relieve fatigue, stress and depression.
Parents will also need to consider how they will feed their newborn. Many parents want to nurse their babies, given the many benefits for infant development. Nursing can also be beneficial to the lactating parent in their postpartum recovery, but sometimes there can also be complications. This recent study from 2020 showed that breast massage and acupressure can support lactation and prevent mastitis.
And what about massage for the baby? Massage for babies in the NICU improved their growth and development in their first two weeks of life. Massage has also been found to reduce the symptoms of colic which has a huge impact on parent stress levels. There are also benefits “by proxy” when parents massage their babies. This study from 2016 saw a correlation between infant massage performed by the birth giver and a reduction of postpartum depression symptoms and another showed that infant massage increased bonding and attachment between parents and babies.
Therapeutic massage can positively impact our generation’s experience of the childbearing years and support mindful parenting. If we access this tool to support our journeys through conception, pregnancy, postpartum, and even learn how to connect with our infants through caring touch, we can see the ripple effects through the rest of our lives, and theirs.
Kiera Nagle, MA, LMT (she/her), has been practicing massage and reiki for over a dozen years. Kiera is the Director of the Asian Holistic Health and Massage Therapy Program at Pacific College of Health and Science, NY Campus. She is the creator of MaMassage®, a protocol for treating clients in the childbearing years, and a training curriculum for massage therapists. Kiera is a DONA-trained birth doula, and a certified pediatric massage therapist. She was the 2018 Massage Therapy Foundation Community Service Grant recipient for her collaboration with Womankind, providing massage for survivors at this NYC based organization serving survivors of gender-based violence. Kiera is the proud parent of a pretty cool middle school kid. Kiera has trained hundreds of massage therapy students and is grateful for the rewarding nature of a career in massage therapy. Many of the techniques referenced in this article, such as acupressure, reflexology, and aromatherapy, are part of the foundational training in the massage therapy program at Pacific College. If you are interested in learning more about this wellness career path, and serving clients with various needs and conditions, read more here.